How to Pay for In-Home Care
How to Pay for Home Care in Washington
Jump to a state to see its Medicaid programs, waivers, and other ways to help pay for in-home care.
This directory lists Washington-specific and federal payment sources that can pay for, reimburse, offset, or help plan for home care. Some are direct payment sources; others are indirect supports that reduce the amount of private home care a family must buy. Washington's strongest state-specific pathways include the WA Cares Fund state long-term-care insurance benefit, Community First Choice (CFC), COPES with the New Freedom self-directed option, MAC/TSOA supports for unpaid caregivers, the DDA waivers (Basic Plus, Core, IFS, Community Protection, CIIBS), and SCSA and other Family Caregiver Support programs, and VA benefits are broken out because they can be one of the strongest payment pathways for eligible Washington veterans and surviving spouses.
Updated August 2026
Reviewed by Valerie VanBooven, RN, BSN
Washington State / Long-Term Care Insurance
WA Cares Fund
Yes / broad LTSSHelps pay for: State long-term-care insurance benefit for vested eligible workers. In 2026, the full benefit amount is $36,500 and grows automatically with inflation; it can be used for approved long-term-care services and supports.
Who qualifies: Must meet WA Cares contribution and care-needs requirements. Benefits became available July 1, 2026; applicants generally must need help with at least three listed activities of daily living and expect the need to continue at least 90 days.
How to start: Check eligibility and benefit balance through WA Cares, then use an approved service/provider pathway.
Good to know: Family caregiver payment: Yes, including a spouse, if the family caregiver becomes an eligible paid provider
Washington State / WA Cares
WA Cares In-Home Personal Care
YesHelps pay for: Can pay for qualifying in-home help with bathing, dressing, mobility, toileting, meal preparation, household tasks and other approved long-term-care needs.
Who qualifies: WA Cares eligibility plus an approved care need and covered provider/service.
How to start: Start a WA Cares benefit application and select covered in-home services.
Good to know: Family caregiver payment: Sometimes
WA Cares Paid Family Caregiver
YesHelps pay for: WA Cares can compensate a qualifying family caregiver for approved in-home care, including a spouse, after the caregiver becomes an employee of an approved provider pathway such as Consumer Direct Care Network Washington or a registered home-care agency.
Who qualifies: The beneficiary must be approved for WA Cares benefits; the family caregiver must complete the applicable provider/employment, background and training requirements before paid services begin.
How to start: Ask WA Cares how the selected family caregiver can become an eligible provider.
Good to know: Family caregiver payment: Yes, including spouse
WA Cares Home Safety, Equipment & Other Supports
Offsets care costHelps pay for: Benefit dollars may be used for approved equipment, home-safety changes, transportation, meals, caregiver supports and other covered LTSS that can reduce paid-care hours.
Who qualifies: WA Cares eligibility and covered-service rules; obtain approval before major purchases or modifications.
How to start: Review covered benefits before purchasing equipment or modifying the home.
Good to know: Family caregiver payment: No direct wage unless caregiver service is separately covered
Washington Apple Health / LTSS
Apple Health Long-Term Services & Supports / Home and Community Services
YesHelps pay for: Entry point for Medicaid long-term-care assessment and programs that help eligible older adults and adults with disabilities remain at home.
Who qualifies: Apple Health financial eligibility plus functional/service criteria that vary by CFC, COPES, MPC and other LTSS pathways.
How to start: Contact Home and Community Services or Community Living Connections for an LTSS assessment.
Good to know: Family caregiver payment: Depends on program/provider relationship rules
Washington Medicaid / State Plan
Community First Choice (CFC)
YesHelps pay for: Medicaid state-plan HCBS for people who meet institutional level-of-care criteria; can authorize personal care and other community supports.
Who qualifies: Apple Health eligibility, institutional level of care and assessed need for CFC services.
How to start: Request an HCS or DDA functional assessment and ask whether CFC applies.
Good to know: Family caregiver payment: Often, through a qualifying Individual Provider; relationship rules apply
Medicaid Personal Care (MPC)
YesHelps pay for: State-plan personal care for certain Apple Health clients who need help with daily activities but do not receive CFC under the same eligibility pathway.
Who qualifies: Apple Health eligibility and MPC functional/financial criteria; current program interactions with CFC should be confirmed during assessment.
How to start: Request an HCS/DDA assessment and ask whether MPC or CFC applies.
Good to know: Family caregiver payment: Sometimes via qualifying Individual Provider
Washington Medicaid / CFC
CFC Personal Care
YesHelps pay for: Hands-on or supervisory assistance with ADLs/IADLs and health-related tasks in the home or community.
Who qualifies: CFC eligibility and authorized hours/tasks; worker must meet Individual Provider or agency requirements. Legally responsible-person rules can differ by relationship and service. DSHS states that spouses cannot be paid to care for each other through Apple Health Medicaid LTSS, and parents cannot be paid to care for a child under 18.
How to start: Ask the case manager about agency care versus an Individual Provider.
Good to know: Family caregiver payment: Yes for qualifying family/friends; not spouse-to-spouse or parent of child under 18
CFC Skills Acquisition Training
Offsets care cost / partialHelps pay for: Training that helps an eligible participant learn or maintain skills needed to perform personal-care tasks more independently.
Who qualifies: CFC eligibility, assessed need and plan authorization.
How to start: Ask the case manager whether skills-acquisition training can be added to the plan.
Good to know: Family caregiver payment: No
CFC Personal Emergency Response System (PERS)
Offsets care costHelps pay for: Emergency-response technology can support independent living and reduce the need for continuous paid supervision.
Who qualifies: CFC eligibility and authorization based on assessed need.
How to start: Ask the case manager about PERS or similar emergency-response technology.
Good to know: Family caregiver payment: No
CFC Assistive Technology / Caregiver Management Supports
Offsets care costHelps pay for: Approved technology and caregiver-management supports can improve independence and make a person-centered care plan easier to manage.
Who qualifies: CFC eligibility and current benefit/service-plan rules.
How to start: Discuss technology, training and support needs during the CFC assessment.
Good to know: Family caregiver payment: No direct wage
CFC Relief Care
Yes - relief careHelps pay for: Short-term relief care can cover the participant when an unpaid primary caregiver needs a break or is temporarily unavailable.
Who qualifies: CFC eligibility, presence of an unpaid caregiver and authorization under current CFC rules.
How to start: Ask the case manager whether relief care is appropriate.
Good to know: Family caregiver payment: No continuous caregiver wage
Washington Medicaid / HCBS Waiver
COPES Waiver
YesHelps pay for: HCBS waiver for eligible adults who would otherwise need nursing-facility care; supplements CFC/state-plan services with additional community supports.
Who qualifies: Apple Health financial eligibility, nursing-facility level of care, assessed need and waiver service-plan authorization.
How to start: Request an HCS assessment and ask whether COPES is needed in addition to state-plan services.
Good to know: Family caregiver payment: Personal-care worker may be a qualifying family/friend; Medicaid LRI exclusions apply
Washington Medicaid / COPES
COPES Adult Day / Adult Day Health
Offsets care cost / day servicesHelps pay for: Daytime supervision, activities and health-related supports can reduce the number of paid in-home hours needed.
Who qualifies: COPES eligibility and service-plan authorization; local provider availability applies.
How to start: Ask the COPES case manager about adult day options.
Good to know: Family caregiver payment: No
COPES Home-Delivered Meals
Offsets care costHelps pay for: Authorized meals can reduce food costs and caregiver time spent on meal preparation.
Who qualifies: COPES eligibility and assessed need; meal service must be included in the plan.
How to start: Request meal-support screening through the COPES case manager.
Good to know: Family caregiver payment: No
COPES Environmental Modifications
Offsets care costHelps pay for: Approved accessibility or safety changes can help a person remain at home and reduce hands-on assistance needs.
Who qualifies: COPES eligibility; modification must be allowed, necessary and approved before work begins.
How to start: Discuss the need with the case manager before signing a contractor agreement.
Good to know: Family caregiver payment: No
COPES Specialized Equipment & Supplies
Offsets care costHelps pay for: Approved equipment and supplies can support safe community living and reduce caregiver burden.
Who qualifies: COPES eligibility, assessed need and authorization; items must meet waiver criteria.
How to start: Ask the case manager/clinician about allowable equipment.
Good to know: Family caregiver payment: No
COPES Transportation / Community Supports
Partial / offsetHelps pay for: Certain transportation and other waiver supports may be authorized when they are necessary to maintain community living.
Who qualifies: COPES eligibility and current waiver/service-plan rules.
How to start: Ask the case manager which transportation/community supports are available locally.
Good to know: Family caregiver payment: No
Washington Medicaid / Self-Direction
New Freedom Consumer-Directed Services Waiver
Yes / flexibleHelps pay for: Self-directed Medicaid waiver option that provides an individual budget to purchase approved services, supports and goods instead of using only traditional agency-delivered care.
Who qualifies: Must meet Medicaid/New Freedom functional and financial eligibility and live in the current service area: King, Pierce, Spokane, Whitman, Stevens, Pend Oreille or Ferry County.
How to start: Contact HCS/AAA in one of the seven participating counties and request New Freedom enrollment information.
Good to know: Family caregiver payment: Yes, subject to worker and relationship rules
New Freedom Individual Budget & Workers
YesHelps pay for: Participant directs an approved budget and can recruit/manage workers and purchase authorized supports that meet person-centered goals.
Who qualifies: New Freedom enrollment, approved budget and worker/provider requirements.
How to start: Work with the New Freedom consultant to develop the spending plan and hire eligible workers.
Good to know: Family caregiver payment: Yes, subject to program rules
Washington Medicaid / Individual Provider
Consumer Directed Employer / Individual Provider (CDWA)
YesHelps pay for: Washington’s Consumer Directed Employer system handles payroll, credentialing and employment administration for many Individual Providers selected by clients receiving Medicaid personal care.
Who qualifies: Client must have authorized Individual Provider hours; worker must complete hiring, background/credentialing and training requirements. DSHS states that spouses cannot be paid to care for each other through Apple Health Medicaid LTSS, and parents cannot be paid to care for a child under 18.
How to start: Ask the case manager to authorize an Individual Provider and complete hiring through Consumer Direct Care Network Washington.
Good to know: Family caregiver payment: Yes for qualifying family/friends; not spouse-to-spouse or parent of child under 18
Washington Medicaid / Medical
Apple Health Home Health
Yes - skilled careHelps pay for: Can cover medically necessary intermittent skilled nursing, therapy and qualifying home-health services when ordered and furnished under Apple Health rules.
Who qualifies: Apple Health coverage, medical necessity, provider enrollment and authorization requirements.
How to start: Ask the treating clinician and Apple Health plan/provider about a home-health referral.
Good to know: Family caregiver payment: No
Washington Medicaid / End of Life
Apple Health Hospice
Yes - hospiceHelps pay for: Can cover hospice services for eligible Medicaid members with a qualifying terminal illness, including symptom management and family/caregiver support.
Who qualifies: Apple Health eligibility, hospice election/clinical criteria and enrolled provider requirements.
How to start: Ask the physician or Apple Health plan for a hospice evaluation.
Good to know: Family caregiver payment: No
Washington Medicaid / Integrated Care
PACE
YesHelps pay for: Program of All-Inclusive Care for the Elderly can coordinate medical care and long-term services, including home care, adult day, transportation and other supports.
Who qualifies: Generally age 55+, live in a PACE service area, meet nursing-facility level of care and be able to live safely in the community with PACE services.
How to start: Check whether a PACE organization serves the ZIP code and request an eligibility assessment.
Good to know: Family caregiver payment: No direct family wage
Washington Medicaid / Transition
Roads to Community Living (RCL)
Offsets care cost / transitionHelps pay for: Money Follows the Person transition program that can help eligible Medicaid residents move from institutions back to a home/community setting and arrange transition supports.
Who qualifies: Medicaid, qualifying institutional stay and RCL transition criteria; person must want and be able to transition safely.
How to start: Ask the facility social worker or DSHS transition specialist about RCL.
Good to know: Family caregiver payment: No
Washington Medicaid / Caregiver Support
Medicaid Alternative Care (MAC)
Caregiver support / respiteHelps pay for: Alternative Medicaid benefit designed to support an unpaid caregiver of an eligible adult age 55+ so the care recipient can remain at home without using a full Medicaid LTSS package.
Who qualifies: Care recipient generally must be 55+, meet functional/financial criteria and have an unpaid caregiver; program eligibility and service limits apply. As of August 2026, DSHS reports new enrollment is paused and a waitlist has been in place since December 1, 2025.
How to start: Contact HCS or Community Living Connections to confirm current waitlist status and request screening/placement on the waitlist if appropriate.
Good to know: Family caregiver payment: No continuous wage
Washington State / Caregiver Support
Tailored Supports for Older Adults (TSOA)
Caregiver support / respiteHelps pay for: State/federally supported program for certain adults age 55+ who are not otherwise eligible for Medicaid LTSS; can support an unpaid caregiver or an older adult without a caregiver.
Who qualifies: Age 55+ plus program income/resource, functional and caregiver criteria; not the same as Medicaid LTSS. As of August 2026, DSHS reports new enrollment is paused and a waitlist has been in place since December 1, 2025.
How to start: Contact HCS or Community Living Connections to confirm current waitlist status and request screening/placement on the waitlist if appropriate.
Good to know: Family caregiver payment: No continuous wage
Washington Aging / Caregiver Support
Family Caregiver Support Program
Partial / respiteHelps pay for: Local aging-network services can provide caregiver assessment, counseling, training, respite, support groups and limited supplemental services.
Who qualifies: Caregiver and care-recipient eligibility follows Older Americans Act/state rules; local funding and service availability vary.
How to start: Contact the local Area Agency on Aging or Community Living Connections.
Good to know: Family caregiver payment: No continuous wage
Washington State / Older Adults
Senior Citizens Services Act (SCSA)
Yes / subsidizedHelps pay for: State-funded services for eligible older adults who need help remaining at home and are not fully served by Medicaid or other programs.
Who qualifies: Generally age 60+; local assessment, income/cost-share and funding rules apply.
How to start: Contact the local Area Agency on Aging or contracted SCSA provider.
Good to know: Family caregiver payment: Usually no direct family wage
Washington State / SCSA
SCSA In-Home Personal Care / Homemaker
Yes / subsidizedHelps pay for: Local SCSA-funded in-home services may help with personal care, housekeeping, meal preparation and other tasks needed for safe community living.
Who qualifies: SCSA/local eligibility and available funding; services and cost share vary by county.
How to start: Ask the local AAA about SCSA in-home services.
Good to know: Family caregiver payment: Usually no
Washington Aging / Adult Day
Adult Day Services
Offsets care cost / day careHelps pay for: Adult day programs can provide supervision, meals, activities and health supports, reducing the number of in-home caregiver hours needed for appropriate participants.
Who qualifies: Program-specific age/functional criteria, local funding and cost share apply. Medicaid/waiver coverage may also be available for some participants.
How to start: Ask the local AAA, HCS case manager or Medicaid plan about adult day options.
Good to know: Family caregiver payment: No
Washington Aging / Nutrition
Home-Delivered Meals / Senior Nutrition
Offsets care costHelps pay for: Meals and safety checks for eligible older/homebound adults can reduce food costs and caregiver meal-preparation time.
Who qualifies: Older Americans Act/local nutrition criteria; priority often goes to frail, homebound or isolated adults.
How to start: Contact the local AAA or senior nutrition provider.
Good to know: Family caregiver payment: No
Washington Aging / Transportation
Senior & Disability Transportation
Offsets care costHelps pay for: Local aging/disability programs may subsidize medical or essential transportation, reducing caregiver driving time and transportation spending.
Who qualifies: Local program rules, service area, funding and trip-purpose limits apply.
How to start: Ask Community Living Connections or the local AAA about transportation resources.
Good to know: Family caregiver payment: No
Washington Aging / Home Safety
PERS, Assistive Technology & Home-Safety Supports
Offsets care costHelps pay for: Local aging programs and Medicaid services may help with emergency-response devices, assistive technology or home-safety changes that reduce supervision needs.
Who qualifies: Program-specific eligibility and local funding; Medicaid authorization may be required for Medicaid-funded items.
How to start: Ask the AAA/HCS case manager about the least-cost applicable program before purchasing.
Good to know: Family caregiver payment: No
Washington DDA / HCBS Waiver
Basic Plus Waiver
Partial / supportsHelps pay for: DDA waiver for eligible people with developmental disabilities living in the community; can add respite, therapies and other supports to state-plan services.
Who qualifies: DDA eligibility, waiver enrollment, assessed need and available capacity/funding.
How to start: Contact the DDA case resource manager and ask about Basic Plus eligibility/services.
Good to know: Family caregiver payment: Sometimes; service-specific family rules apply
Core Waiver
Yes / broad supportsHelps pay for: Higher-support DDA waiver that can fund residential/community supports and other services for people with significant needs.
Who qualifies: DDA eligibility, Core waiver criteria, assessed need and available capacity.
How to start: Ask the DDA case resource manager about Core waiver options.
Good to know: Family caregiver payment: Service-specific rules apply
Community Protection Waiver
Yes / specialized supportsHelps pay for: Specialized DDA waiver for eligible adults who need intensive community-based supervision/treatment supports to live safely outside an institution.
Who qualifies: DDA eligibility plus Community Protection criteria and service-plan authorization.
How to start: Work with DDA if the person meets Community Protection criteria.
Good to know: Family caregiver payment: Generally through qualified providers
Washington DDA / Self/Family Supports
Individual & Family Services (IFS) Waiver
Partial / supportsHelps pay for: DDA waiver focused on supports for people living with family or in their own homes, including respite and other approved services.
Who qualifies: DDA eligibility, IFS enrollment/budget and person-centered plan requirements.
How to start: Ask DDA about IFS waiver enrollment and the annual service allocation.
Good to know: Family caregiver payment: Sometimes, depending on service and worker rules
Washington DDA / Children
Children’s Intensive In-Home Behavioral Supports (CIIBS) Waiver
Yes / in-home supportsHelps pay for: Intensive in-home behavioral and family supports for eligible children with developmental disabilities and high behavioral-support needs.
Who qualifies: Child must meet DDA/CIIBS eligibility and intensive behavioral-support criteria; waiver capacity applies.
How to start: Contact DDA and request CIIBS screening.
Good to know: Family caregiver payment: Family payment depends on service/provider rules
Washington DDA / Respite
DDA Respite
Yes - respiteHelps pay for: Short-term care can give an unpaid caregiver a break and may be authorized through DDA waivers or other DDA programs.
Who qualifies: DDA eligibility, approved respite hours/budget and provider qualifications; relationship restrictions apply to some family members.
How to start: Ask the DDA case resource manager about respite authorization and eligible providers.
Good to know: Family caregiver payment: No continuous caregiver wage; some relatives may qualify as respite providers subject to rules
Washington DDA / Home Safety
DDA Environmental Adaptations
Offsets care costHelps pay for: Approved home modifications can improve access and safety for eligible waiver participants and reduce hands-on assistance needs.
Who qualifies: Applicable DDA waiver eligibility, assessed need and prior authorization.
How to start: Discuss the proposed modification with DDA before contracting for work.
Good to know: Family caregiver payment: No
Washington DDA / Technology
DDA Assistive Technology / Specialized Equipment
Offsets care costHelps pay for: Approved equipment and technology can support communication, independence, safety and community living.
Who qualifies: DDA/waiver eligibility and service-specific medical/functional necessity rules.
How to start: Ask DDA which waiver or state-plan benefit can cover the needed item.
Good to know: Family caregiver payment: No
Washington DDA / Clinical Supports
DDA Skilled Nursing / Nurse Delegation Supports
Yes - skilled/health-relatedHelps pay for: Some DDA/Apple Health service plans can include nursing, nurse delegation or health-related supports that enable a person to remain safely at home.
Who qualifies: DDA/Apple Health eligibility, clinical need and service-plan/provider requirements.
How to start: Ask the DDA case manager and treating clinician about nursing/nurse-delegation options.
Good to know: Family caregiver payment: No
Washington Medicaid / 1115 HRSN
Health-Related Social Needs (HRSN) Supports
Partial / respite / cost offsetHelps pay for: New 1115-demonstration supports include caregiver respite, nutrition supports, home accessibility/remediation/adaptation, community transition services and certain rent/temporary-housing supports.
Who qualifies: Eligible Apple Health members must meet HRSN and service-specific criteria. Washington implemented current HRSN rules in 2026 through HCS and DDA; authorization and service limits apply.
How to start: Ask HCS or DDA whether the member qualifies for HRSN caregiver respite, nutrition, transition or home-accessibility supports.
Good to know: Family caregiver payment: No continuous caregiver wage
Medicare Counseling
Washington SHIBA
Offsets household costHelps pay for: Free, unbiased Medicare counseling can identify Medicare Savings Programs, Extra Help and coverage options that preserve household funds for care.
Who qualifies: Medicare beneficiary/caregiver; services are free.
How to start: Contact SHIBA through the Office of the Insurance Commissioner.
Good to know: Family caregiver payment: No
Medicare Cost Reduction
Medicare Savings Programs (QMB / SLMB / QI)
Offsets household costHelps pay for: Can pay Medicare premiums and, for QMB, certain Medicare cost-sharing, preserving income for home care.
Who qualifies: Medicare plus income/resource rules; program category determines help level.
How to start: Apply through Washington Apple Health/DSHS or get SHIBA help.
Good to know: Family caregiver payment: No
Prescription Cost Reduction
Medicare Part D Extra Help
Offsets household costHelps pay for: Federal subsidy can reduce Part D premiums, deductibles and prescription copays, freeing household income for care.
Who qualifies: Medicare and income/resource rules; some people qualify automatically.
How to start: Apply through Social Security or ask SHIBA for assistance.
Good to know: Family caregiver payment: No
Medicare
Medicare Home Health
Yes - limited/skilledHelps pay for: Medicare may cover intermittent skilled nursing, therapy and limited home health aide care when home-health eligibility requirements are met.
Who qualifies: Must meet Medicare home-health criteria, including need for skilled services and homebound requirements under current rules.
How to start: Ask the treating clinician for a Medicare-certified home-health referral.
Good to know: Family caregiver payment: No
Medicare Caregiver Training Services
Training / offsetHelps pay for: Medicare may cover caregiver training when it is needed to help a caregiver safely support a beneficiary’s treatment plan.
Who qualifies: Medicare coverage rules and clinician/provider requirements apply.
How to start: Ask the treating clinician whether covered caregiver training is appropriate.
Good to know: Family caregiver payment: No wage
Medicare / Dementia
GUIDE Model Dementia Care
Partial / respiteHelps pay for: Participating GUIDE organizations can provide dementia care coordination, caregiver support and respite services for eligible Medicare beneficiaries.
Who qualifies: Medicare beneficiary with dementia and other model criteria; must be served by a participating GUIDE organization.
How to start: Use CMS/Medicare resources to identify a participating GUIDE provider serving the area.
Good to know: Family caregiver payment: No continuous wage
Medicare / End of Life
Medicare Hospice
Yes - hospiceHelps pay for: Medicare hospice can provide nursing, medications/equipment related to the terminal illness, aide services and caregiver support when eligibility criteria are met.
Who qualifies: Medicare hospice eligibility and election requirements.
How to start: Ask the physician or hospice provider for an evaluation.
Good to know: Family caregiver payment: No
Medicare Advantage
Medicare Advantage Supplemental In-Home Benefits
Sometimes / limitedHelps pay for: Some Medicare Advantage plans offer limited in-home support, meals, transportation, caregiver supports or other supplemental benefits.
Who qualifies: Benefits vary by plan, county, eligibility and year; prior authorization/network rules may apply.
How to start: Check the plan Evidence of Coverage or ask SHIBA to compare benefits.
Good to know: Family caregiver payment: Usually no
Cash Assistance
Aged, Blind or Disabled (ABD) Cash Assistance
Cash / indirectHelps pay for: State cash assistance for certain low-income adults who are aged, blind or likely to meet disability criteria; cash can help with household expenses while care funding is arranged.
Who qualifies: Washington residency plus ABD income/resource and age/disability requirements.
How to start: Apply through Washington Connection/DSHS.
Good to know: Family caregiver payment: Yes, indirectly
Housing Cost Reduction
Housing and Essential Needs (HEN) Referral Program
Offsets household costHelps pay for: For certain low-income adults unable to work due to a physical or mental condition, HEN may provide housing/essential-needs support through local providers.
Who qualifies: Must meet HEN referral and incapacity/financial rules; local provider availability and housing eligibility apply.
How to start: Apply through DSHS for HEN referral, then contact the local HEN provider.
Good to know: Family caregiver payment: No
Food Cost Reduction
Basic Food (SNAP)
Offsets household costHelps pay for: Monthly food assistance can reduce grocery spending and preserve cash for care.
Who qualifies: Household income and program eligibility rules apply.
How to start: Apply through Washington Connection/DSHS.
Good to know: Family caregiver payment: No
Senior Farmers Market Nutrition Program
Offsets household costHelps pay for: Seasonal produce benefits for qualifying older adults can reduce food spending.
Who qualifies: Age 60+ (or applicable tribal eligibility), income and seasonal/local availability rules apply.
How to start: Apply through the local participating agency during the enrollment period.
Good to know: Family caregiver payment: No
Energy Cost Reduction
Low-Income Home Energy Assistance Program (LIHEAP)
Offsets household costHelps pay for: Helps eligible households with heating/energy costs, preserving income for care.
Who qualifies: Income, household and local agency funding rules apply.
How to start: Contact a local LIHEAP provider through Washington Commerce.
Good to know: Family caregiver payment: No
Home Cost Reduction
Weatherization Assistance Program
Offsets household costHelps pay for: Energy-efficiency and health/safety improvements can reduce utility costs and make the home safer for an older adult or person with disability.
Who qualifies: Income, housing and local provider eligibility rules apply.
How to start: Contact the local weatherization provider before arranging work.
Good to know: Family caregiver payment: No
Property Tax Relief
Senior / Disabled Person Property Tax Exemption
Offsets household costHelps pay for: Qualifying homeowners may receive property-tax relief, preserving household income for care.
Who qualifies: Age/disability, income, ownership/occupancy and application rules apply; county assessor administers the program.
How to start: Apply through the county assessor.
Good to know: Family caregiver payment: No
Property Tax Deferral for Qualifying Homeowners
Offsets household cost / cash flowHelps pay for: Eligible homeowners may defer certain property taxes, improving near-term cash flow for care, although deferred amounts generally remain a lien/obligation.
Who qualifies: Program-specific age/disability, income, equity and occupancy rules apply.
How to start: Ask the county assessor or Department of Revenue about deferral eligibility.
Good to know: Family caregiver payment: No
Income / Employment
Senior Community Service Employment Program (SCSEP)
Offsets household costHelps pay for: Part-time community-service employment can provide income and training for eligible low-income adults age 55+, helping offset household and care costs.
Who qualifies: Age 55+, income and program eligibility; openings depend on local grantees.
How to start: Ask the local SCSEP provider or workforce agency about enrollment.
Good to know: Family caregiver payment: No
Insurance / Private Funding
Long-Term Care Insurance / Washington Partnership Policies
Yes, policy-dependentHelps pay for: Private long-term-care insurance may reimburse qualifying home care; Partnership-qualified policies can provide Medicaid asset-protection advantages if policy benefits are exhausted and Medicaid rules are met.
Who qualifies: Policy definitions, elimination period, benefit triggers, covered providers and family-caregiver rules vary by contract.
How to start: Review the policy and request a written benefit eligibility determination before hiring care.
Good to know: Family caregiver payment: Sometimes, policy-dependent
Workers Compensation
Washington L&I Home Nursing / Attendant Care
SometimesHelps pay for: For a compensable workplace injury, workers’ compensation may cover medically necessary home nursing or attendant-care services when authorized.
Who qualifies: Must relate to an accepted workers’ compensation claim and meet medical/authorization requirements.
How to start: Ask the claim manager, treating provider or attorney about home-care coverage.
Good to know: Family caregiver payment: Sometimes, case-specific
VA Benefits
Veteran-Directed Care
YesHelps pay for: Provides a flexible self-directed budget for eligible Veterans needing personal care; workers may include family or neighbors subject to local program rules.
Who qualifies: Enrolled Veteran; community-care eligibility, clinical criteria and local VDC availability.
How to start: Ask the VA social worker specifically whether Veteran-Directed Care is available locally.
Good to know: Family caregiver payment: Yes
VA Aid & Attendance Pension Add-On
Cash / indirectHelps pay for: Additional monthly pension amount for qualifying Veterans/survivors who need help with daily activities or meet other Aid & Attendance criteria; cash can be used toward care.
Who qualifies: Must qualify for VA Pension plus Aid & Attendance medical/functional criteria and financial rules.
How to start: Apply through VA or an accredited Washington veterans service officer.
Good to know: Family caregiver payment: Yes, indirectly
VA Homemaker & Home Health Aide
YesHelps pay for: VA may pay an authorized community aide to help an eligible Veteran with ADLs and selected daily tasks.
Who qualifies: VA enrollment/community-care eligibility, clinical need and local availability; copay may apply. Ask VA primary care/social work for assessment and authorization.
How to start: Ask the VA social worker or care team about VA Homemaker & Home Health Aide.
Good to know: Family caregiver payment: No
Veteran-Directed Care (VDC)
YesHelps pay for: Flexible self-directed budget for eligible Veterans needing personal care; workers may include family or neighbors subject to local program rules.
Who qualifies: Enrolled Veteran; community-care eligibility; clinical need; VDC must be available locally. Ask the VA social worker specifically about Veteran-Directed Care.
How to start: Ask the VA social worker or care team about Veteran-Directed Care (VDC).
Good to know: Family caregiver payment: Yes
VA Skilled Home Health
Yes - skilled careHelps pay for: VA may purchase skilled nursing, therapy and related home-health services from authorized community providers.
Who qualifies: Clinical need, VA eligibility and authorization/local provider availability. Ask the VA care team for skilled home-health assessment/referral.
How to start: Ask the VA social worker or care team about VA Skilled Home Health.
Good to know: Family caregiver payment: No
VA Respite Care
Yes - respiteHelps pay for: VA may arrange in-home, adult-day or nursing-home respite to give an eligible caregiver a break.
Who qualifies: Clinical need, VA enrollment and local availability; authorization may apply. Ask the caregiver support coordinator/social worker.
How to start: Ask the VA social worker or care team about VA Respite Care.
Good to know: Family caregiver payment: No
VA Aid & Attendance
Cash / indirectHelps pay for: Additional pension amount for qualifying Veterans/survivors who need help with daily activities, are bedridden, have severe visual impairment or meet nursing-home criteria.
Who qualifies: Must be eligible for VA Pension and meet Aid & Attendance criteria. Apply through VA or an accredited representative/VSO.
How to start: Ask the VA social worker or care team about VA Aid & Attendance.
Good to know: Family caregiver payment: Yes, indirectly
Program of Comprehensive Assistance for Family Caregivers (PCAFC)
Direct caregiver stipendHelps pay for: May pay an approved primary family caregiver a monthly stipend and provide training, counseling, respite and other supports.
Who qualifies: Veteran and caregiver must meet PCAFC eligibility and complete VA assessment/enrollment. Apply jointly through VA Caregiver Support.
How to start: Ask the VA social worker or care team about Program of Comprehensive Assistance for Family Caregivers (PCAFC).
Good to know: Family caregiver payment: Yes
VA Community Care Network - Region 4
Pays authorized providerHelps pay for: VA-authorized community care can include home health and other approved services. Washington is in CCN Region 4, administered by TriWest.
Who qualifies: VA referral/authorization and community-care eligibility generally apply. Obtain VA authorization before routine community care; do not assume reimbursement after private hire.
How to start: Ask the VA social worker or care team about VA Community Care Network - Region 4.
Good to know: Family caregiver payment: No
VA Pension
Cash / indirectHelps pay for: Monthly needs-based pension for qualifying wartime Veterans with limited income/net worth; pension cash can help fund care.
Who qualifies: Wartime service, age/disability, discharge, income/net-worth and other VA pension rules apply. Apply through VA or an accredited VSO.
How to start: Ask the VA social worker or care team about VA Pension.
Good to know: Family caregiver payment: Yes, indirectly
Home Improvements and Structural Alterations (HISA)
Offsets care costHelps pay for: VA HISA grants may pay for medically necessary home changes that improve access to essential areas or permit treatment at home.
Who qualifies: Eligibility, medical justification, lifetime limit and project requirements apply. Ask VA prosthetics/primary care about HISA before construction.
How to start: Ask the VA social worker or care team about Home Improvements and Structural Alterations (HISA).
Good to know: Family caregiver payment: No
VA Adult Day Health Care
Offsets care cost / day careHelps pay for: VA may provide or purchase adult day health services, including supervision, activities and health-related care, reducing in-home caregiver hours.
Who qualifies: VA enrollment, clinical need and local availability/authorization. Ask the VA social worker or geriatric care team.
How to start: Ask the VA social worker or care team about VA Adult Day Health Care.
Good to know: Family caregiver payment: No
VA Hospice & Palliative Care
Yes - hospice/palliativeHelps pay for: VA can provide or purchase hospice/palliative services, including symptom management and caregiver support in the home or other settings.
Who qualifies: VA enrollment, clinical criteria and care-team authorization. Ask VA physician/social worker for palliative or hospice evaluation.
How to start: Ask the VA social worker or care team about VA Hospice & Palliative Care.
Good to know: Family caregiver payment: No
Program of General Caregiver Support Services (PGCSS)
Support / respite navigationHelps pay for: Provides education, coaching, peer support, respite/navigation and other support for family caregivers of enrolled Veterans without requiring PCAFC stipend eligibility.
Who qualifies: Caregiver supports an eligible Veteran enrolled in VA health care; specific services vary. Contact VA Caregiver Support.
How to start: Ask the VA social worker or care team about Program of General Caregiver Support Services (PGCSS).
Good to know: Family caregiver payment: No direct stipend
Where Washington Families Can Start
Not sure where to begin? Match your situation to a contact below.
WA Cares eligibility, benefit access, covered services and paid-family-caregiver pathway
WA Cares Fund
No-wrong-door aging and disability navigation, caregiver support, meals, transportation and local in-home programs
Community Living Connections / Local AAA
CFC, COPES, MPC, MAC, TSOA, New Freedom and Medicaid LTSS assessments
DSHS Home & Community Services
Medicaid coverage questions, long-term care, home health, hospice and PACE information
Apple Health / HCA
Consumer Directed Employer hiring/payroll support for authorized Individual Providers
Consumer Direct Care Network Washington
DDA waivers, respite, CIIBS, IFS, Basic Plus, Core and related disability supports
DSHS Developmental Disabilities Administration
Transition from institutional care back to a home/community setting
Roads to Community Living
Free Medicare counseling, MSP/Extra Help and plan comparison
Washington SHIBA
Basic Food, ABD cash, HEN referral and other income supports
Washington Connection / DSHS
Senior/disabled property-tax exemption and deferral applications
County Assessor
Accredited VSO help with Aid & Attendance, Pension and VA claims
Washington Department of Veterans Affairs
Before You Rely on Any Payment Source
Planning Point
Why It Matters
WA Cares is separate from Medicaid
WA Cares is state long-term-care insurance based on contribution/vesting and care need; CFC/COPES are Medicaid programs with financial and functional eligibility. Screen for both rather than assuming one replaces the other.
WA Cares started benefits July 1, 2026
Benefits became available July 1, 2026. The full 2026 benefit is $36,500 and grows with inflation. WA Cares can pay a qualifying family caregiver, including a spouse, after provider/employment requirements are met.
Family caregiver rules differ by program
WA Cares can pay a qualifying spouse. By contrast, DSHS states Apple Health Medicaid LTSS cannot pay spouses to care for each other and cannot pay a parent to care for a child under 18. New Freedom, DDA respite and VA programs have additional service-specific rules.
CFC and COPES often work together
CFC is a Medicaid state-plan benefit; COPES is a waiver that can add services. A person may receive CFC personal care plus COPES waiver supports rather than choosing only one.
New Freedom is not statewide
New Freedom currently serves King, Pierce, Spokane, Whitman, Stevens, Pend Oreille and Ferry counties. Verify service-area and enrollment rules before building a self-directed budget plan.
MAC and TSOA support caregivers, not ongoing wages
These programs support unpaid caregivers rather than providing a continuous caregiver salary. DSHS reports new enrollment has been paused with a waitlist since December 1, 2025; verify current status before relying on access.
DDA waiver services are service-specific
A DDA waiver does not automatically make every relative a paid provider. Respite, nursing, personal care and other services each have their own provider and relationship rules.
Use Individual Provider authorization before hiring
For Medicaid personal care, the client needs authorized hours and the worker must complete CDE/CDWA hiring and qualification steps before Medicaid payment can begin.
Avoid duplicate billing
Do not bill two public programs for the same service, worker and time period. Coordinate WA Cares, Medicaid, Medicare, VA and private insurance so each source pays only allowable non-duplicative costs.
Medicare is not long-term custodial care insurance
Medicare home health is primarily for qualifying skilled/intermittent care; it generally does not fund ongoing stand-alone custodial personal care.
Cost offsets can preserve care dollars
Food, energy, property-tax, prescription and transportation programs may not pay a caregiver, but reducing those expenses can materially extend a private-pay home-care budget.
Verify annual changes
WA Cares benefit amounts, Medicaid standards, waiver service definitions, Medicare plans and local grant funding can change. Recheck source links and case-manager guidance before relying on a dollar amount or service limit.
Program rules, income limits, and availability change over time and can vary by county. Confirm current details with the program directly, or ask a home care provider in Washington to help you navigate the application process.
← Back to How to Pay for In-Home CareHome Care Providers in Washington
These providers serve families in Washington and can help you apply what you've learned above to your specific situation.
Cascade Senior Services
Serving Washington
Cascade Senior Services provides home care services in University Place, WA and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
University Place, Tacoma, Lakewood and surrounding areas
View Provider Profile →
Love In Home Senior Care
Serving Washington
Love In Home Senior Care provides home care services in Spokane, WA and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Spokane
View Provider Profile →
Revere Home Care
Serving Washington
Revere Home Care provides home care services in Issaquah, WA and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Issaquah, Seattle, Bellevue and surrounding areas
View Provider Profile →
Vibrant Health Homecare
Serving Washington
Vibrant Health Homecare provides home care services in Tacoma, WA and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Bonney Lake, Edgewood, Fife and surrounding areas
View Provider Profile →
Welcome Home Care – Omak, WA
Serving Washington
Welcome Home Care provides home care services in Omak, WA and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Brewster, Chelan, Grand Coulee and surrounding areas
View Provider Profile →
Welcome Home Care – Wenatchee, WA
Serving Washington
Welcome Home Care provides home care services in Wenatchee, WA and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Brewster, Chelan, Grand Coulee and surrounding areas
View Provider Profile →